| NPI | 1881903235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LAUREN CRAWFORD Doctor/President 512-732-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX N5640) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |